NPIMap

Organization Active NPI

Good Samaritan Hospital Corvallis

  • Family Medicine Physician
  • Corvallis, OR
National Provider Identifier
1447516281
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GOOD SAMARITAN HOSPITAL CORVALLIS
Practice address
114 Gill Coliseum
Room 62-63
Corvallis, OR 97331-8547
Phone
(541) 737-4527
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Becky Pape
Title
Coo
Phone
(541) 768-5009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

114 Gill Coliseum
Room 62-63
Corvallis, OR 97331-8547

Mailing address

114 Gill Coliseum
Room 62-63
Corvallis, OR 97331-8547
Phone (541) 737-4527

Other identifiers 1

IdentifierTypeStateIssuer
500651537MedicaidOR

Other names 1

  • Samaritan Sports Medicine-G Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000163 OR Part B Supplier - Clinic/Group Practice 1557270725 Receives reassigned benefits from 589 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Corvallis, OR; Albany, OR

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Regional Med50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Locations

114 Gill Coliseum
Rm 6263
Corvallis, OR 97331
Phone (541) 737-4527

3620 NW Samaritan Dr
Ste 202
Corvallis, OR 97330
Phone (541) 768-4810

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1447516281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GILL COLISEUM",
            "address_2": "ROOM 62-63",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318547",
            "telephone_number": "541-737-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GILL COLISEUM",
            "address_2": "ROOM 62-63",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318547",
            "telephone_number": "541-737-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN HOSPITAL CORVALLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "PAPE",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "541-768-5009"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500651537",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan Sports Medicine-G",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.